Routemap - Hwb

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Things to look for
Look for any changes in behaviour which are not reflex responses, for example:
stilling (a momentary pause)
turning (head, eyes or body)
lip/tongue movement
nostrils flaring
an eye flicker
a change in breathing
tensing or relaxing (you may need to be in close physical contact in order to perceive this)
Examples
Amelia glanced fleetingly towards the light source when it was presented in the dark corner.
Ieuan moved his arm slightly when it was stroked with a soft material.
Assessment activities/things to try
Introduce a stimulus, then pause.
Present vibration, e.g. massager or vibrating cushion.
Smear a small amount of a taste on the learner’s lips.
Hold a jar of something strong-smelling under the learner’s nose.
Place the learner’s hand on a hot-water bottle covered with soft fabric, on something rough textured like sandpaper, or under a flow of warm water.
Play music or a familiar song; use musical instruments.
Present a torch reflected on a shiny surface. If there’s no response, try moving it slightly.
Distinguishing this step from others
The learner’s behaviour shows a change of some kind in the presence of the stimulus. This change of behaviour is not obviously a reflex (e.g. a startle), nor a response to some internal sensation (e.g. discomfort or hunger). The change in behaviour may be fleeting and low in intensity. It may only occur in the presence of very specific or arresting stimuli and in very controlled sensory environments (e.g. a dark room).
The specific change of behaviour may only be noticeable following very careful systematic observation and recording and by those who know the learner well. Where ‘noticing’ relates to the visual modality, this step is consistent with Level V of the eyePoint Scale (Other Visual Behaviours):
Acknowledging the presence of objects without clearly fixing on them.
Visual attention given to objects is fleeting and not repeated (University College London and Great Ormond Street Hospital: Eye‑Pointing Classification Scale).
Teaching strategies (to move the learner towards this step)
Using two staff, one supporting the learner in a sitting position and one at the front, try gently pulling the learner backwards and forwards, and then pausing.
Try different parts of the body (soles of feet or back of neck may be more sensitive areas).
Try moving the learner’s hand (especially the fingertips) in sheepskin, gel, warm water, etc.
Try sounds of different frequencies, timbre and duration.
In a darkened corner, present a repeated pattern of ‘stimulus: no-stimulus’, i.e. light: no light.
Box 1 is in Theme 1: Responding to stimuli (the themes can be viewed in the assessment booklet)
Things to look for
Look for any changes in behaviour which are not reflex responses, for example:
stilling (a momentary pause)
turning (head, eyes or body)
lip/tongue movement
an eye flicker
a change in breathing
tensing or relaxing (you may need to be in close physical contact in order to perceive this)
Examples
Nadia will curl into our body if one of us hugs her on their lap. In this position, she will start to smile if we sing one of her favourite nursery rhymes.
When nervous, Lee wants contact to be closer and holds the adult tight. He will sometimes vocalise when on our lap and we chat to him.
Assessment activities/things to try
Hold the learner and talk or sing, leaving pauses for any response.
Distinguishing this step from others
The learner’s behaviour shows a change of some kind while they are in close physical contact with someone they know well.
This change of behaviour is not obviously a reflex (e.g. a startle), nor a response to some internal sensation (e.g. discomfort or hunger).
It can be interpreted as a response to the familiar adult or to something the familiar adult is doing.
The change in behaviour may be fleeting and/or low in intensity.
Teaching strategies (to move the learner towards this step)
Choose the learner’s strongest sense to start.
If the learner responds best to auditory stimuli, try talking and singing close to the learner, with pauses for careful observation of possible responses.
If the learner responds well to visual stimuli, try getting close and exaggerating your facial expression.
Then combine visual with auditory input.
Box 2 is in Theme 2: Responding to people (the themes can be viewed in the assessment booklet)
Things to look for
Look for:
a change in activity level
vocalising
opening of the mouth/tongue movement
moving fingers, e.g. in sheepskin
a kick
Examples
Jack opened his eyes wide and moved his head up when the light changed in the dark room.
Megan responds to wafts of warm air from a fan with short vocalisations and excited movements of her arms.
Assessment activities/things to try
Present an obvious stimulus to the learner in a similar way to Routemap milestone 1 (Notices stimuli), taking care not to cause a startle. Use the information you have gathered about preferred sense modalities and record outcomes.
Try new tastes in the form of a lip balm smear.
Try a vibrating cushion, resonance board or a water bed.
Present different textures, such as warm sand, with which the learner can engage. Apply them to different parts of the body.
Try using musical instruments, tapes and musical toys.
Use peek-a-boo, puppets and pop-up toys.
Distinguishing this step from others
The learner’s behaviour changes in the presence of the stimulus. It is not a reflex, nor a response to something internal.
When compared to the change in behaviour recorded for Routemap milestone 1 (Notices stimuli), it:
is greater in intensity
may incorporate larger, less fleeting movements
may coincide more obviously with the stimulus
may occur more readily and more frequently
Teaching strategies (to move the learner towards this step)
Increase the range, complexity and variety of stimuli you used in Routemap milestone 1 (Notices stimuli). The level of prompting/exaggeration used should be gradually reduced to a more natural level.
If the learner has only shown a response in one sense modality up to this point, then you should seek to extend this to other available senses. Consider your positioning in relation to the learner’s visual field/auditory ability etc. (see ‘Barriers to learning’ on pages 36–41 of Routes for Learning: Guidance).
Take care when presenting an ‘unexpected’ stimulus not to cause a startle reaction. It is good practice to warn the learner of forthcoming events by touch or voice.
Care must be taken with regard to placement/positioning of visual stimuli. Consider the learner’s visual field. Avoid the learner having to look up as this may cause stiffening and/or backwards movement (seek advice from a physiotherapist).
Box 3 is in Theme 1: Responding to stimuli (the themes can be viewed in the assessment booklet)
Things to look for
Look for:
a decline in interest when the stimulus is repeated
recovery of interest when a new stimulus is offered
Examples
During a visual tracking session, Leila was initially interested when the shiny card was presented. When it was taken away and then re-presented her attention span was much shorter and she quickly lost interest.
Meilyr showed an interest in the book as it was ‘read’ to him, but looked away after about half a minute. After a short break, the book was presented again but this time he only looked for about ten seconds. Then the book was replaced with some bells; he was much more responsive to these and sustained his interest for 28 seconds.
Assessment activities/things to try
Present the stimulus to the learner. When the learner stops attending, immediately remove and re-present the stimulus (the gap should be less than three seconds if possible). Use a stopwatch.
If the learner attends for a shorter time to the second presentation, it is likely that the learner has remembered the stimulus. (You may need to try this several times to be sure.)
N.B. The stimulus should be neutral (not the face of a familiar adult, not food).
Try using a black and white chequerboard.
Distinguishing this step from others
The learner responds to a stimulus by looking or listening intently for a period of time.
When the learner loses interest, the stimulus is briefly removed.
When re-presented, the learner again attends but for less time than previously.
On further re-presentations of the same stimulus, the learner attends less and less, or not at all.
When a new stimulus is presented, the period of interest is much longer.
Teaching strategies (to move the learner towards this step)
Increase the gaps, looking for evidence of recognition memory (see ‘Habituation’ on page 30 of Routes for Learning: Guidance).
Use a variety of stimuli.
Show a new stimulus, rather than the same stimulus again. Look for a recovery of interest.
Box 4 is in Theme 3: Responding to pattern in repetition (the themes can be viewed in the assessment booklet)
Things to look for
Look for:
stilling/tensing or relaxing
smiling or a change in facial expression
turning of the head
fleeting eye contact
reaching out/touching
Examples
Kamal will cry if he is supported by someone he doesn’t know (e.g. supply staff) but will calm when one of the familiar staff takes over. He smiles if he sees or hears his taxi escort nearby.
Carys is very aware of different voices. She will turn as soon as she hears her father’s voice as he comes through the classroom door.
Assessment activities/things to try
Sit close to the learner – hug/touch.
Move towards the learner, speaking or singing.
Draw attention to particular features, e.g. exaggeration of a facial expression, the feel of long hair, a perfume smell, etc.
Distinguishing this step from others
The learner’s response to a person they know very well is different from their response to a stranger.
When someone very familiar is near, the learner calms down, or continues to be relaxed. They may turn towards or otherwise show interest in that person.
Their response to someone unfamiliar is likely to appear more neutral, anxious or uncertain. If in distress, they may not be comforted.
Teaching strategies (to move the learner towards this step)
Ensure that all practitioners who are in regular contact with the learner have a personal identifier or action. This should ideally be an integral part of each person, e.g. long hair, a beard, etc.
Encourage voice recognition – use the learner’s name on approach and talk using consistent language.
For learners with a visual or hearing impairment, a personal, tactile sign may be used.
If the learner is tactile defensive, try other senses.
Box 5 is in Theme 2: Responding to people (the themes can be viewed in the assessment booklet)
Things to look for
Look for:
a change in activity level or facial expression
movement of eyes, lips, tongue
vocalisation
tensing/relaxing
movement of arms/legs/fingers
Examples
Sean happily explored soft, furry materials, but when presented with brushes and sandpaper, he pulled his hands away.
Seren seems to like the soft textures of our ‘sea’ sensory story but not the feel of cold water; she pulled her hands out. She will splash her hands in warm water. She seems to like chocolate to taste, but appears not to be keen on bland mashed potato.
Assessment activities/things to try
Develop activities you used previously for Routemap box 3 (Responds to very obvious stimulus), increasing the range, complexity and variety of stimuli.
Distinguishing this step from others
The learner responds to a wider range and variety of different stimuli.
The range of stimuli may extend beyond those specifically designed to give strong sensory stimulation.
Some responses may occur outside of controlled sensory environments.
As in Routemap box 3 (Responds to very obvious stimulus), the learner’s behaviour in the presence of the stimuli is easy to detect, and can be readily interpreted as a response.
The learner may now show responses in a number of sensory modalities and it is becoming easier to discern stimuli they like or dislike.
Teaching strategies (to move the learner towards this step)
Further increase the range, complexity and variety of stimuli you used in Routemap milestone 1 (Notices stimuli).
Gradually reduce prompting and level of stimulation to a more natural level.
If the learner has only shown a response in one sense modality up to this point, then you should seek to extend this to other available senses. Consider your positioning in relation to the learner’s visual field/auditory ability, etc. (see ‘Barriers to learning’ on pages 36 to 41 of Routes for Learning: Guidance)
In addition, see the information regarding Routemap box 3 (Responds to very obvious stimulus).
Box 6 is in Theme 1: Responding to stimuli (the themes can be viewed in the assessment booklet)
Things to look for
Look for changes in the learner’s behaviour, e.g. looking, smiling at the adult, vocalising, especially during a pause.
Examples
Manon enjoys being swung in a familiar person’s arms. The teaching assistant swings her for ten seconds, then pauses, waiting for Manon to laugh. When she does, the teaching assistant says “More?” then swings her again. They repeat this as a turn-taking game.
When I strum the guitar and then leave a pause, Harry will often vocalise during the silence.
Assessment activities/things to try
Support the learner in a rocking game, e.g. ‘Row your boat’.
Support the learner coactively to return/push the ball to an adult, accompanying your actions by ‘Ready, steady, go!’
In conversation, take turns – talk animatedly, leave pauses for a ‘reply’.
Present/re-present a toy or object (visual/musical/vibrating), taking turns and facilitating the learner to take their turn.
Distinguishing this step from others
The learner makes a response after the adult has:
provided a clear, or even exaggerated, opportunity to take turns
prompted the learner to respond and have a turn
The timing of the learner’s response can be interpreted as being ‘their turn’.
Additionally, the environment has been carefully arranged to support the learner’s requirements.
The communication partner is physically close and is present throughout.
Teaching strategies (to move the learner towards this step)
Use a member of staff to support the learner in taking turns, e.g. holding the learner, working hand-over-hand, coactively, etc.
Leave time for the learner to initiate a response.
Box 7 is in Theme 4: Signalling preferences (the themes can be viewed in the assessment booklet)
Things to look for
Look for the learner responding in the same way each time a stimulus is presented.
It should be noted that for a variety of reasons the responses of learners with PMLD may not be ‘consistent’ from day to day.
Examples
Aaron always smiles when he hears the voice of his taxi guide.
Sioned does not like the sound made by hook-and-loop fasteners and flinches every time she hears them torn apart.
Assessment activities/things to try
Present a familiar visual/auditory/tactile/other sensory stimulus which has been used consistently with the learner.
Repeat in the same way several times (but not so often that the learner ‘habituates’ or gets bored of the stimulus).
Distinguishing this step from others
The learner responds in a similar way each time when a specific stimulus is repeatedly presented.
The learner’s behaviour in the presence of the stimulus can be readily interpreted as a response.
In relation to the learner’s ‘looking’ behaviour, this step corresponds with Level IV of the eyePoint Scale (Fixes Gaze):
‘Consistent active ability to fix and hold gaze on … a stationary target’ (University College London and Great Ormond Street Hospital: Eye‑Pointing Classification Scale).
Teaching strategies (to move the learner towards this step)
Check that the learner is comfortable and secure (see ‘Some key principles for effective learning’ on page 32 of Routes for Learning: Guidance).
Box 9 is in Theme 1: Responding to stimuli (the themes can be viewed in the assessment booklet)
Things to look for
Look for the learner responding in a different way to:
one kind of object or sensory experience compared to another
one sensory modality (e.g. a sound) as opposed to another (e.g. a taste or a smell)
objects and sensory experiences as opposed to interactions with people
Examples
Martin loves being sung to in Welsh and will always respond with animation to Welsh music and speech. He does not like having his hands placed into cold water or paint and loud music makes him jump.
Tahayra will pick her head up when we leave the school building to go out into the fresh air. She will look up at the lights as we move from one part of the building to another. Tahayra laughs if tickled but pulls away and cries at massage on her arm. She completely ignores bubbles, but rocks back and forward when loud music is playing.
Assessment activities/things to try
Present stimuli believed to be strongly liked or disliked and note the learner’s reactions.
Do stimuli believed to be liked get different, broadly consistent reactions to those believed to be disliked?
Distinguishing this step from others
The learner demonstrates a number of different behaviours when responding to a range of stimuli.
Differences in their responses provide clear evidence of personal preferences.
Teaching strategies (to move the learner towards this step)
Try additional strong stimuli in a variety of modalities. Repeat on a number of occasions.
After consulting a physiotherapist try the following.
Place the learner on a thick blanket with the head supported and sweep and swirl the blanket along a slippery floor, building in pauses for a response.
Give the learner a taste/smear of something they are likely to like/dislike, e.g. something with a strong, distinctive taste such as yeast extract, lemon juice, rhubarb, chocolate or strawberry. Different flavoured lip balms could also be used.
Present eucalyptus or another strong smell from a smell bank.
N.B. Do not repeatedly present stimuli which get a ‘dislike’ reaction on the same occasion. Instead acknowledge the learner’s communication and remove the stimulus.
Box 12 is in Theme 1: Responding to stimuli (the themes can be viewed in the assessment booklet)
Things to look for
After repeated alternate presentations, look for the learner turning their eyes, head or body part to the next position before the stimulus appears there.
When sound, vibration or light, etc. is presented in a pulse pattern, look for the learner anticipating the next presentation, e.g. the body may stiffen or the eyes widen before the next presentation of a sound.
Examples
The bell was rung behind James, first on the right and then the left, several times in succession. He turned each time towards the side from which it was played. After one re-presentation on the right, I waited and he turned to the left in anticipation. We tried something similar with ‘peek-a-boo’ birds which emerged alternately from two holes, again on a pause his gaze moved to the next anticipated position.
Martha can anticipate the next location of a light or sound stimulus when presented in an alternating pattern. When I stood behind her on the trampoline and leaned down first to one side and then the other, she turned in anticipation of the direction I would next appear from.
Assessment activities/things to try
Try the following with the learner.
Present a visual stimulus alternately in two different positions.
Present a single sound in a regular repetitive pulse pattern.
Place a vibrating brush, massager, etc., on two different parts of the learner’s body alternately.
Distinguishing this step from others
After the learner has experienced a stimulus being presented first in one location then in another and this pattern has been repeated, the learner’s eyes, head or other relevant part of the body move towards the next location in the pattern but before the stimulus appears there.
Teaching strategies (to move the learner towards this step)
If there is no response, try sparkly/twinkly items such as fibre optics, lights or fluorescent rods under ultraviolet light. Blow on alternate sides of the learner’s face or blow a raspberry on different parts of body. If the learner has a visual impairment and is slow to develop anticipation, return to Routemap box 12 (Responds differently to different stimuli) and emphasise tactile sense.
Box 14 is in Theme 3: Responding to pattern in repetition (the themes can be viewed in the assessment booklet)
Things to look for
Look for the learner:
moving their fingers or hand
smelling or trying to lick or mouth objects
actively exploring objects in turn
Examples
Kayleigh laughed as sand was sprinkled over her feet; she then moved her feet in the sand.
Peter coactively felt a feather boa during our story and continued to hold on to it.
Assessment activities/things to try
Place the learner’s hand on an interesting object and assist them to feel it, then pause.
Distinguishing this step from others
The learner demonstrates a response provided that:
the environment has been carefully arranged to support their requirements
an adult is physically close and is present throughout
the adult has initiated the interaction by (at least):
bringing the material to the learner
bringing the learner’s hand, foot, etc. to the material
Teaching strategies (to move the learner towards this step)
Place the learner’s hand or foot in warm water; agitate the water.
Pour sand over the learner’s hand or foot.
Bury the learner’s foot in sand, shaving foam, jelly or slime.
Use a ball pool, feely bags, etc.
Box 16 is in Theme 6: Acting on the physical environment (the themes can be viewed in the assessment booklet)
Things to look for
Look for:
independent (but random) movement of hands or fingers
active exploration by the mouth or other parts of the body
the learner’s reaction to any ‘effects’ created
Examples
Anwen moved her feet when the space blanket was placed underneath them. The noise seemed to interest her.
Li rolled about on the musical mat in the light room causing the music to play.
Assessment activities/things to try
Place the learner on a reactive surface, e.g. a space blanket or resonance board.
Distinguishing this step from others
The learner makes something happen close to them provided that the:
environment has been carefully arranged so that a movement within the learner’s repertoire encounters the target material(s)
materials produce strong sensory effect(s) which are not obviously ignored or disliked by the learner
The adult does not need to be continuously present and does not provide physical support to enable the action(s) to happen.
Teaching strategies (to move the learner towards this step)
Use a range of surfaces or toys which react to touch (e.g. a survival blanket, an interactive floor mat, a sound beam, a Bobo doll). You could also use a ‘little room’. Provide opportunities for the learner to have an effect ‘by chance’ on the immediate environment (e.g. knocking a noisy toy). Reinforce these actions, prompting a repeat and ensuring a consistent result.
Box 19 is in Theme 9: Connecting actions with outcomes (the themes can be viewed in the assessment booklet)
Things to look for
Look for the learner making attempts to create an action or effect.
Examples
Owen will eagerly bash the resonance board to create a range of sounds. When placed on a noisy space blanket, he wriggles and kicks enthusiastically.
Sarah will explore sensory materials placed very near her, such as beads that sparkle under lights. She will also use her hand to make sounds on the chimes and pulls fibre optics closer to her.
Assessment activities/things to try
Place the learner on an interesting reactive surface and note the response.
Distinguishing this step from others
The learner makes something happen more than once provided that the:
environment has been carefully arranged for them to do so
materials involved (are designed to) provide strong sensory effect(s)
The learner shows clear interest in the effect(s) produced.
The adult does not need to be continuously present and does not provide physical support to enable the action(s) to happen.
Teaching strategies (to move the learner towards this step)
Use physical or verbal prompts to initiate exploration, then reduce the frequency of the prompts. Draw the learner’s attention to the effects created.
Box 21 is in Theme 6: Acting on the physical environment (the themes can be viewed in the assessment booklet)
Things to look for
Look for the learner vocalising/moving/changing facial expression, for example:
widening their eyes, staring at an object
moving their arms
opening their mouth or vocalising
reaching towards an object, in a way which may be interpreted as a request for more
Examples
Sophie is working with the physiotherapist. She is enjoying reaching out to hit an electronic keyboard. When the therapist turns away to write herself a note, Sophie waves her hands towards the keyboard, frowning.
If Isaac is giving a staff member a cuddle and they pull away, he will reach out and pull them back in for more cuddles. When a snack is gone, he will bang the table until he is given more.
Assessment activities/things to try
Engage the learner in an enjoyable activity. Break the activity at a critical point, pause, and await the learner’s response. For example:
during eating, pause, holding the food in front of mouth
during singing, pause in an action song
pause while beating on a resonance board
Distinguishing this step from others
While engaged in an interaction with a partner, the learner makes a response which can be interpreted as ‘I like that action or stimulus and will accept more of it’.
The response occurs during a pause (their ‘turn’).
The learner may not be intentionally affecting the communication partner’s actions, but a sensitive communication partner can understand/interpret their behaviour.
The ‘more’ responses are likely to depend on the type of stimulus (e.g. smell, action, taste, sound, smell, texture), but do not rely on a familiar context.
Teaching strategies (to move the learner towards this step)
Using stimuli to which the learner has a consistent response, build up a pattern. Pause within the pattern and interpret the learner’s next response as a request for more. For example, while offering food on a spoon, pause just before putting the spoon in the mouth and interpret the learner’s next response (e.g. lips opening) as ‘more’.
Extend the distance of the spoon from the mouth. Lips closing could mean ‘no more’.
Pause during bouncing or a resonance board activity with an action song. Interpret body movement or a facial expression as a request for more.
Box 22 is in Theme 4: Signalling preferences (the themes can be viewed in the assessment booklet)
Things to look for
Look for:
the learner making something happen independently
the rate of action increasing when it has an effect, e.g. kicking increases when it causes a mobile to move
whether or not the learner waits for a reward to finish before pressing a switch again
Examples
Martina knew that she had to press the touchscreen to make something happen and did so repetitively. She continued to do so all the time the reward was playing.
Jordan swipes the chimes repeatedly, without waiting for the sound he’s created to die away first.
Assessment activities/things to try
Using an action which you have established that the learner can do (e.g. kicking, pressing a switch), use a reward and observe the rate of response.
Distinguishing this step from others
The learner acts successfully to make something happen (the reward).
They demonstrate some degree of interest in the reward.
After experiencing success, they keep repeating the action.
Their actions do not seem to be timed to coincide with the reward ending and may be just as frequent while the reward is still happening.
Teaching strategies (to move the learner towards this step)
At this stage the learner may not fully understand the connection between their action and the outcome. Ensure the action obtains a consistent result to help the learner establish this link.
A particularly effective technique may be to attach a string to the learner’s ankle enabling them to move a mobile – the more the learner kicks, the more the mobile moves. This technique ensures that the learner receives good feedback.
Box 23 is in Theme 9: Connecting actions with outcomes (the themes can be viewed in the assessment booklet)
Things to look for
Look for the learner acting with intent and more consistently, for example:
waiting for a reward to end before trying again, linking a particular action with its consequence
a change in facial expression or concentration
increasing accuracy
Examples
Sam will press a switch to activate a hairdryer or a music player; he smiles when he sees it has been activated and waits. Once it has stopped he will reach out to press again.
Eira hits her drum and then waits and listens as the music teacher plays the same pattern in response. She then hits the drum again.
Assessment activities/things to try
Provide a switch for a toy or provide a wobbly toy, wind chimes, etc., which can be operated by an action that the learner has already acquired.
Distinguishing this step from others
The learner acts purposefully to make something happen.
This action is not repeated while the reward operates.
They attend closely to the reward and may show pleasure and excitement.
They repeat their action only when the reward has finished.
Teaching strategies (to move the learner towards this step)
Encourage the same action to obtain a variety of effects. Ensure that every repeat of the action is successful.
Box 26 is in Theme 9: Connecting actions with outcomes (the themes can be viewed in the assessment booklet)
Things to look for
Look for a response which may indicate ‘no more’, e.g. eyes closing, turning away, closing of the mouth. Reinforce and build upon this, responding consistently on every occasion.
Examples
We know Mira wants ‘more’ because she uses sustained eye contact, smiles and reaches out. We know she means ‘no more’ when she turns away, refuses eye contact or pushes us away.
It is usually clear from Jake’s facial expression that he wants ‘more’ and he will sometimes vocalise at the same time. However, when he’s had enough he will close his eyes while someone is talking and if they don’t stop he will turn his face away.
Assessment activities/things to try
Observe the learner’s reactions to a less preferred activity or food, etc. Note the actions which may indicate ‘no more’. This should be distinct from the action(s) used to indicate ‘more’.
Distinguishing this step from others
While engaged in an interaction with a partner, the learner displays two distinct kinds of response:
responses which can be interpreted as ‘I like that and will accept more of it’
other responses which can be understood as ‘I don’t like that’ or ‘I don’t want more of that’
Such responses are used quite consistently in different contexts and often occur during a pause in an interaction (the learner’s turn).
The learner’s preferences can be understood by unfamiliar communication partners.
Teaching strategies (to move the learner towards this step)
Note even a slight response or change in expression to an activity which the learner wishes to end. Reinforce and shape this behaviour by saying or coactively signing ‘finished/no more’ and clearly finishing the activity.
Box 28 is in Theme 4: Signalling preferences (the themes can be viewed in the assessment booklet)
Things to look for
Look for an example such as the learner missing a switch the first time, or failing to depress it sufficiently, but trying again and succeeding.
Examples
If an object is placed just out of reach, Sophia will try several times to reach it. If the object is moved closer in small steps she will continue to reach for it in the same way until finally she is successful.
Leon tried to grasp a toy that was floating away in the pool. He reached out repeatedly as I moved him slowly in its direction, until eventually he got hold of it.
Assessment activities/things to try
Try:
moving the learner’s switch slightly
changing the surface to make a toy harder to move
using an adjustable pressure switch, increasing the pressure of the switch slightly
Distinguishing this step from others
The learner attempts to make something happen, but doesn’t succeed.
The learner repeats the original action (perhaps more than once).
There is no attempt to change the action itself although the learner may, for instance, reach a little further or press a little harder.
Teaching strategies (to move the learner towards this step)
You may wish to encourage problem-solving by moving the position of the switch slightly. However, beware of confusing or frustrating the learner.
This step can be taught in a range of situations (i.e. not just using switches and other forms of technology).
Box 31 is in Theme 11: Solving problems (the themes can be viewed in the assessment booklet)
Things to look for
Look for the learner:
looking towards the point of disappearance for a brief time
stilling, turning their head or changing their facial expression when a noise stops
searching briefly by feeling on a tray for an item removed from their grasp
searching more actively or for a longer duration
Examples
When an adult stands directly in front of Abi and hides a favourite toy behind their back, she will pull on them to try and turn them around or stretch her arm out towards where it is hidden.
Rhys actively looked for his drink bottle, pulling the lid off a box after watching it being placed inside. He also pulled aside a screen behind which his toy car had been hidden.
Assessment activities/things to try
Engage the learner’s attention with a shiny, noisy or furry object. Then, either move the item out of sight, keep it quiet or move it just out of reach. Does the learner ‘search’ for the item?
Distinguishing this step from others
The learner focuses on a stimulus.
If the stimulus moves, the learner’s eyes follow it to the point where it disappears from view and continue to look there afterwards.
If the stimulus does not move but is covered over, the learner’s gaze remains fixed on, or returns to, the place where they last saw it before it was obscured.
They ‘search’ for the stimulus visually, through touch, or by listening more intently in its direction.
Teaching strategies (to move the learner towards this step)
If there is no response to the object being removed from the field of attention:
try partially covering the object, or use a see-through cloth
use a moving object under the cloth
Ensure that the learner’s attention is focused on the place from where the object disappeared (e.g. make a noise with it from just outside the learner’s field of vision), then bring the object back into sight for a short time from this direction.
Prompt the learner’s hand to reach for the object in the direction in which it was moved away.
Box 34 is in Theme 5: Keeping track of objects (the themes can be viewed in the assessment booklet)
Things to look for
Look for:
increased eye contact with one item
a greater change in facial expression in response to one noise when two are presented in an alternating pattern; leave enough time for any responses
an increased level of activity (e.g. arm or leg movements) during a pause following a taste of one particular food
Examples
We moved Casper onto a mat on the floor, after putting a toy on each side of the mat. He manoeuvred himself towards the flashing tambourine, whichever side it was on, and spent time playing with it, even when we swapped its location several times.
Lowri was given a plate containing pieces of banana and soft broad beans. She chose to eat all of the banana, piece by piece, but didn’t touch any of the beans.
Assessment activities/things to try
Present two items to which the learner will respond, e.g. brightly coloured or noisy toys, a smell, a taste of drink, etc. Observe the learner to see if the response to one item lasts longer, or whether there is an obvious change in activity level.
Distinguishing this step from others
The learner selects one item when both/all items are presented together and are equally accessible (i.e. within their reach/view).
They have previously had the opportunity to see/manipulate each of the items individually (especially if the learner has a visual impairment).
The learner’s focus is on one preferred item and their reach (if any) is clearly an attempt to grasp or manipulate the item itself. Their actions do not appear designed to communicate anything to another person.
Teaching strategies (to move the learner towards this step)
Offer two items in a variety of situations.
Include one item known to be preferred by the learner.
Change the position/order of items over several presentations.
Allow the learner to explore and make their own selection. (Try not to prompt them to ‘choose’.)
Box 36 is in Theme 12: Choosing options (the themes can be viewed in the assessment booklet)
Things to look for
Look for:
smiling
eye pointing
reaching
turning towards a preferred item
Examples
Craig’s facial expression changes when an adult picks up his favourite toy or snack visible among others.
Anna reaches towards the toy she wants, eye‑pointing towards it, sometimes glancing towards the adult.
Assessment activities/things to try
Offer two items simultaneously. Observe the learner closely for obvious or increased attention to one of the items which communicates their preference.
Distinguishing this step from others
The learner indicates their interest in one particular item:
when both/all items are presented together
even if the items are out of their reach
when the position/order of items is randomised over several presentations
The learner’s behaviour, while focused on a preferred item (as in Routemap box 36 (Selects from two or more items)), is not just an attempt to physically obtain it.
Their behaviour here also acts as a ‘signal’ to the other person – for instance, it may look more like a ‘gesture’, might incorporate some degree of direct eye contact or indicate an apparent response to a communication partner.
Teaching strategies (to move the learner towards this step)
Offer a preferred item alongside a non-preferred item. If there is no clear response to the preferred item, either move it, bring it closer or cause it to make a noise to attract the learner’s attention. Try this with a variety of objects and situations, changing the position/order of items over several presentations.
Box 37 is in Theme 12: Choosing options (the themes can be viewed in the assessment booklet)
Things to look for
Look for all unprompted attempts to gain adult attention, in particular at times when an adult is not expecting them. Strategies can be taught (e.g. pressing a particular switch which could be present on a tray or chair) but they must come to be used on the learner’s terms not just after adult encouragement.
Examples
When Ryan wants to come out of his chair (or up from the floor), he will vocalise loudly to gain the attention of one of the class team, holding his arms up as he does so.
When Melanie is working on her own (e.g. using the computer) and wants something, she bangs the (metal) side of her wheelchair until someone comes over to speak to her.
Assessment activities/things to try
Avoid attending to the learner. Observe the strategies used to gain attention, with no prior intervention. These may include:
vocalising until an adult appears, then stopping
pushing items off a tray and then smiling when an adult appears
stopping activities to press a switch which has consistently been used (with support) to call an adult
Distinguishing this step from others
In the absence of an ongoing social interaction, the learner initiates a request for attention.
The request can be clearly interpreted even by communication partners:
who do not know the learner well
who are not near to the learner at the time
whose attention is elsewhere
Teaching strategies (to move the learner towards this step)
Choose an action in the learner’s repertoire to which an adult can respond consistently by giving attention, for example:
pressing a switch (left available in same position)
vocalising above a certain sound level
moving arms/legs/eyes, etc.
By responding consistently to the action, the adult encourages the learner to carry out the action on future occasions in order to gain adult attention as a reward.
Box 39 is in Theme 10: Acting to engage others (the themes can be viewed in the assessment booklet)
Things to look for
Look for the learner gaining the attention of an adult, for example:
looking towards or indicating a stimulus, and then looking back to the adult
stilling to a sound or moving to music, and then looking back to the adult
touching an item, and then feeling for the adult’s hand
Look for the learner showing pleasure in sharing, or trying to ‘comment’ on the item.
Examples
While sharing a story book with an adult, Olivia looked up at intervals and smiled at the adult, before looking back to the book.
When playing on the plasma screen, Daniel looked at the effect his actions had caused, then looked at me and smiled.
Assessment activities/things to try
Set up a novel or interesting stimulus reasonably close (but out of reach) and wait to see if the learner switches/alternates their gaze between the object and the communication partner.
The learner should join the adult in attending to a stimulus, confirming the attention of the adult visually throughout.
Stroke a dog. Does the learner also touch the dog and smile at the adult?
Point to an item in the near distance. Does the learner look towards the item then back at the adult?
Distinguishing this step from others
The learner:
fixes their gaze on an object, disengages their gaze from the object, then shifts their gaze to the partner’s face and/or
fixes their gaze on the partner’s face, disengages their gaze from the face, shifts their gaze to an object
This step corresponds to Level II of the eyePoint Scale (Shifts gaze to face) (University College London and Great Ormond Street Hospital: Eye‑Pointing Classification Scale).
Within familiar contexts, the learner responds to and initiates joint attention without the support of a familiar social routine.
Teaching strategies (to move the learner towards this step)
Teach joint attention by prompting the learner (verbally or with touch) to look at, listen to, or feel an item of adult choice, then to attend to the adult and the item in turn.
Take the opportunity to share a stimulus to which the learner is attending. Encourage attention to the stimulus and then the adult in turn. This is key for all future communication.
Box 40 is in Theme 7: Being sociable (the themes can be viewed in the assessment booklet)
Things to look for
Look for a reduction in the time during which the learner tries the original action in order to gain a reward.
Look for the learner trying something new.
Examples
After several attempts to get the switch to work, Ben stopped hitting it, picked it up and handed it to me.
If Rachel taps someone standing close to her but they do not respond, she will try coughing in a further attempt to attract their attention.
Assessment activities/things to try
Use an established routine where the learner’s action results in a particular reward. Delay the reward to see if the learner then uses a different action in order to get the reward.
Distinguishing this step from others
The learner attempts to make something happen, but doesn’t succeed using the original action.
They cease repeating or trying to modify the original action and use another action which looks significantly different from the original.
Teaching strategies (to move the learner towards this step)
When the learner recognises that the original strategy will not work, and as soon as an attempt at a new action is made, a reward should be given. As the learner becomes aware that repeating the original action will not work, a new strategy will be attempted more quickly.
Encourage/shape a second, different action when the learner repeatedly tries the first. Try:
prompting the learner to use another action which is in their repertoire – then giving the reward
using computer programmes which require alternate pressing of two switches – reward on the second switch
using single switch programmes where the timing of switch-pressing is important
moving the switch so that the learner needs to use the other hand
Box 42 is in Theme 11: Solving problems (the themes can be viewed in the assessment booklet)
Things to look for
Look for:
attempts to gain adult attention (as above) and make
a request, e.g. vocalising for attention and then touching a symbol on a tray
the learner timing switch-presses to get a desired result in a computer programme
Examples
Jamie vocalised loudly until I stopped what I was doing and came over to him. He then pointed to the sink to indicate that he wanted to play with water. He also gains our attention in this way, then points to his book or points to the cupboard where his drink and snack are kept.
At the end of the school day, Thea calls to her favourite adult in the class and then looks at the lit candle. She persists until they come over and hold the candle so that she can blow it out. She regularly draws our attention in this way to help her achieve other things she wants but is (physically) unable to accomplish on her own.
Assessment activities/things to try
Stand or sit in view of the learner, but do not pay attention to them. Does the learner then try to gain your attention? Does the learner then go on to request an item which is out of sight or reach?
Distinguishing this step from others
The learner both engages a communication partner, using a strategy like vocalising or reaching, and draws their attention to something they want.
The learner engages a communication partner and conveys that they want the partner to do something such as pick them up or tickle them.
The learner applies these strategies in a variety of contexts.
For learners who rely on eye‑pointing, the learner:
fixes their gaze on an object, disengages their gaze from the object, shifts their gaze and fixes on the partner’s face, returns their gaze to fix on the same object
fixes their gaze on the partner’s face, disengages their gaze from the face, shifts their gaze and fixes on the object, returns their gaze to fix on the same partner’s face
This step corresponds to Level I of the eyePoint Scale (Uses Eye‑Pointing) (University College London and Great Ormond Street Hospital. Eye‑Pointing Classification Scale).
Teaching strategies (to move the learner towards this step)
Increase the variety of situations where demands are put on the learner to gain attention and make requests. Ensure that responses from adults are quick and consistent. Do not anticipate the learner’s wants – create opportunities for communication.
Box 43 is in Theme 10: Acting to engage others (the themes can be viewed in the assessment booklet)